Fluorescein Angiography in Retinopathy of Prematurity: Comparison of Infants Treated with Bevacizumab to Those with Spontaneous Regression

Abstract

Objective: Medium and long-term sequelae of intravitreal bevacizumab (IVB) for type 1 retinopathy of prematurity (ROP) are uncertain. Our aim was to describe the fluorescein angiography (FA) findings in patients who received IVB as a primary treatment for type 1 ROP and compare them to findings in patients with spontaneously regressed ROP. Design: Retrospective cohort Participants: Patients with a history of retinopathy of prematurity, who underwent fluorescein angiography between December 1 st , 2013 and July 31 st , 2018. Patients were divided into 2 groups based on whether they had received IVB or had spontaneously regressed. Methods: We reviewed the angiograms in the 2 groups for neovascularization (NV) and other abnormal vascular patterns both in the periphery and the posterior pole. Main Outcome Measures: FA findings including NV, peripheral and macular vascular abnormalities. Results: Forty eyes of 20 infants were included in the IVB group and 16 eyes of 8 infants in the untreated group. Median gestational age was similar in the 2 groups (24.5 & 24.7 weeks respectively; p = 0.44) as was the median birth weight (648.5 & 560.0 g respectively; p=0.26). Median post-menstrual age at the time of FA was 65.1 and 83.9 weeks respectively (p = 0.0002). Review of angiograms demonstrated NV in 30.0% and 37.5% in the IVB and untreated cohorts, respectively (p=0.75). Abnormal vascular patterns in the periphery were similar in both groups

Convolutional Neural Network Based on Fluorescein Angiography Images for Retinopathy of Prematurity Management

“… 15 This and many other reports showed that the use of FA might play a paramount role in the long-term follow-up management of babies treated with antivascular endothelial growth factor (VEGF) agents. 15 – 18 …”

“…14 Recently, Mansukhani et al described the differences on FA between eyes treated with intravitreal injection of bevacizumab and eyes that regressed without treatment and interestingly found frequent abnormal vascular patterns in both groups. 15 This and many other reports showed that the use of FA might play a paramount role in the long-term followup management of babies treated with antivascular endothelial growth factor (VEGF) agents. [15][16][17][18] Furthermore, it is putative that information obtained using FA may provide greater understanding of subtleties of acute-phase ROP.…”

“…15 This and many other reports showed that the use of FA might play a paramount role in the long-term followup management of babies treated with antivascular endothelial growth factor (VEGF) agents. [15][16][17][18] Furthermore, it is putative that information obtained using FA may provide greater understanding of subtleties of acute-phase ROP. 14,19,20 We hypothesized that FA images could be a potential dataset to train a DL algorithm to detect ROP cases requiring treatment.…”

Imaging the pediatric retina: An overview

“…5a and b ]. [ 60 61 62 63 ] FFA is also useful in other pediatric retinal diseases like retinopathy in type 1 diabetes, FEVR, incontinentia pigmenti, dyskeratosis congenital, muscular dystrophy etc., which have a common presentation of peripheral retinal avascularity, progressive neovascularization and early development of tractional retinal detachment. It has helped identify lesser-known clinical and angiographic findings, where these novel findings have led to an updated FEVR classification and more complete characterization of early stages of FEVR.…”

Dynamic Analysis of Ocular Fundus Changes after Different Doses of Bevacizumab in the Treatment of Retinopathy of Prematurity in Threshold Period

“…Clinical studies have found that several doses of bevacizumab treatment have achieved positive results in the treatment of threshold ROP, but the peripheral retina may not continue to vascularize or ROP recurrence may occur after the treatment. Therefore, it is recommended to closely follow up the fundus changes and perform surgical treatment if necessary [3][4][5].…”